Individual provider Active NPI

Benjamin Andrew, M.D.

  • Surgery Physician
  • Summit, WI
National Provider Identifier
1083000863
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
66692-20 Issued in WI
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-1000
NPI assigned
Apr 8, 2015
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 66692-20 WI Primary

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

1860 Shawano Ave
Green Bay, WI 54303-2667
Phone (920) 496-4700

Other practice location 2

707 14th St
Baraboo, WI 53913-1539
Phone (608) 356-1400

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address bandrew371392@ewd.direct.hshs.org Direct
Direct Messaging Address bandrew291784@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address bandrew365845@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812003463 WI Practitioner - General Surgery 2264741552 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Chicago College of Medicine and Surgery, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
66692-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 24, 2020 Accepting new patients
Dean Health Systems, Inc CurrentSince Jul 8, 2024 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Nov 12, 2020 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 10, 2024 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jul 8, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Aug 10, 2024 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Aug 18, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Current Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 24, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Aug 18, 2020 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Nov 12, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1818 N Meade St
Ste 240W
Appleton, WI 54911

707 14th St
Baraboo, WI 53913
Phone (608) 356-1400

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1836 South Ave
#301
La Crosse, WI 54601

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3111 Gundersen Dr
Onalaska, WI 54650
Phone (608) 775-8100

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181

Interoperability endpoints

  • Direct secure messaging: bandrew291784@direct-ehr-ssmhc.com
  • Direct secure messaging: bandrew304938@direct.gundersenhealth.org
  • Direct secure messaging: bandrew365845@direct.myadvocateaurora.org
  • Direct secure messaging: bandrew371392@ewd.direct.hshs.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1083000863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Shawano Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543032667",
            "country_code": "US",
            "telephone_number": "920-496-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 14th St",
            "address_purpose": "LOCATION",
            "city": "Baraboo",
            "state": "WI",
            "postal_code": "539131539",
            "country_code": "US",
            "telephone_number": "608-356-1400",
            "fax_number": "608-355-6810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "66692-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bandrew371392@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1860 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543032667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bandrew291784@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bandrew291784@direct-ehr-ssmhc.com",
            "address_1": "707 14th St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "707 14th St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bandrew365845@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "36500 Aurora Dr",
            "city": "Summit",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Summit, WI

Sources for this page

Verify at the official NPI Registry.